Risk, safety and safeguarding: understanding and application of concepts and implications for integrated care services

SPRU research team

• Yvonne Birks
• Fiona Aspinal

Background

The concepts of safety and safeguarding are well established and commonly used in health and social care. Recent guidance on standards relating to quality and safety from the Care Quality Commission emphasise that these terms apply to all services provided by the NHS, local authorities, private companies and voluntary organisations. The document discusses both concepts and outlines the steps providers need to take to ensure they comply with the regulator and manage risk. In practice, however, the predominance of the terminology is different across different care organisations: health organisations, for example, tend to emphasise 'safety' while social care emphasise 'safeguarding'.

We have two closely related concepts that appear, on the surface at least, to encompass similar principles but which have different names in the worlds of health and social care. With the current policy emphasis on integrated care what challenges could this present? Exploration of these issues in tandem is, as yet, limited. Integration means many things to many people, including integration of organisations, providers and commissioning; improving collaboration and co-ordination with the voluntary and other sectors; or pooling budgets to create integrated health and social care funds. It may also mean integrating governance. There is a dearth of literature exploring the similarities and differences in how the health and social care sectors deal with governance and a lack of evidence about managing governance across sectoral boundaries. It is important to establish whether this lack of congruence in the language and conceptualisation of risk, safety, and safeguarding across sectors, acts as a barrier to closer organisational and inter-professional working. Also whether it is an obstacle to robust mechanisms for governance around these issues.

Aims

This research aims to explore conceptual understandings of risk, safety and safeguarding in different organisational contexts and assess whether any differences might impact on effective integrated service provision or act as barriers to closer working and integration of health and social care.

The research will:

• examine how the terms 'risk', 'safety' and 'safeguarding' are used and understood in different contexts
• explore where, and how, they overlap and diverge
• describe the governance of risk, safety and safeguarding in different contexts
• examine the implications of current understanding, and existing governance, of risk, safety and safeguarding for integrated service provision.

Policy and practice aims

This review will provide the basis for future in-depth work exploring effective shared governance of risk, safety and safeguarding in integrated care by summarising and clarifying what we already know and what gaps exist in the evidence and identifying appropriate research questions.

Professional Press

Community Care, January 14, 2014 Lack of knowledge about practice of care home managers prompts research study

Additional information